Shoulder Injuries Among Swimmers, Surfers Alleviated with Proper Technique, According to Santa Cruz Orthopaedic Institute

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Shoulder impingement problems common from repetitive overhead motions.

Anatomy of a healthy shoulder

Repetitive overhead motions by swimmers and surfers put them at a greater risk for shoulder injuries.

As demonstrated by a number of competitors coming back from shoulder injuries at the U.S. Swimming Trials last week, proper technique and conditioning is important for swimmers, surfers and other summer athletes.

Despite the year-round popularity of water sports in Santa Cruz, shoulder problems increase during summer months as more people swim and surf, according to Dr. Peter Reynolds of Santa Cruz Orthopaedic Institute.

“Swimmers and surfers are at greater risk for shoulder injuries,” said Reynolds. “The repetitive nature of swimming and paddling out in surfing requires an overhead motion of the shoulder, with power and force being applied when the shoulder is the most vulnerable.”

Reynolds also sees increased shoulder issues from those involved in kayaking, boogie boarding, body surfing, rafting, beach volleyball and other popular summer activities.

The medical term is impingement syndrome, formerly known as bursitis or tendonitis. When the arm is overhead and a force is applied, the bursa and rotator cuff tendon pushes against a portion of the shoulder blade called the acromion. Studies have shown two factors come into play: a wringing out of the blood vessels in the tendon and a mechanical pinching of the tendon against the bone.

With overuse, these movements can result in inflammation of both the bursa that cushions and lubricates the tendon and the tendon itself. Overuse is usually doing “too much, too fast” for the joint, but can even occur after a period of rest and a quick return to the sport.

Swimmers and surfers can alleviate their heightened chances of shoulder injuries by recognizing early indicators and with proper technique, according to Reynolds.

Symptoms—pain and occasional popping and clicking in and around the shoulder—are usually worse when moving the arm overhead. Early treatment consists of rest, which is avoiding overhead use of the arm and icing it after any offending activity. Gentle pendulum swinging of the arm can keep the shoulder mobile. Anti-inflammatory medications such as Advil or Aleve can alleviate pain and reduce the inflammation. Shoulder exercises from physicians, physical therapists and other experts can also help.

“Shoulder impingement syndrome is the most common shoulder problem we see in our office,” and usually responds to conservative treatment,” said Reynolds. “Occasionally the problem progresses and we use arthroscopic surgery to trim the bone pinching the rotator cuff. This outpatient procedure has predictably very good results, in the 85-90% success range.”

Obviously, preventing these problems altogether is the best option by paying attention early to pain and stiffness, keeping the shoulder mobile and strong, and resuming swimming and surfing when comfortable.

Competitive swimmers looking for speed and surfers do well to heed advice that goes beyond basic swimming technique. Commonly agreed upon recommendations from exercise physiologists and kinesiologists – swimming with the “lats” not shoulders, stabilizing the scapula, balancing rotator cuff strength and increasing leverage with the forearm paddle – can help avoid injury and increase performance. An excellent primer of these techniques is explained in “How to Swim Faster,” by author and musculoskeletal disorder expert Fred Drennan.

More information on shoulder impingement injuries and prevention, and other orthopaedic issues, is available at, or by calling (831) 475-4024.
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Gail DeLano
DeLano Communications

Randy Kensing, SCOI

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